Improvements in Depressive Symptoms, Perceived Social Support, and Quality of Life Through an Educational Program in Community-Dwelling Older Adults With Frailty Phenotype: A Randomized Controlled Trial of the FRAGSALUD Project

Am J Geriatr Psychiatry. 2025 Aug;33(8):877-890. doi: 10.1016/j.jagp.2025.02.014. Epub 2025 Mar 1.

Abstract

Background: This study examined the impact of an educational program on depressive symptoms, cognitive function, social support, quality of life, and physical frailty among community-dwelling older adults with frailty or prefrailty.

Methods: In this 12-month multicenter randomized controlled trial, 199 frail/prefrail community-dwelling older adults were allocated into the intervention (n = 109) or the control (n = 90) group. The 6-month educational intervention focused on guidelines for physical activity, nutrition, cognition, and psychosocial well-being, while participants in the control group maintained their usual healthcare attendance. Changes in depressive symptoms (15-item Geriatric-Depressive-Scale, GDS-15), cognitive function (Short Portable Mental Status Questionnaire, SPMSQ), social support (Duke-University of North Carolina Functional Social Support Questionnaire, Duke-UNC-11), quality of life (3-level EuroQoL five-dimensional questionnaire visual analog scale, EQ-VAS, and index, EQ-Index), physical frailty (Short Physical Performance Battery, SPPB, and Fried's criteria) were evaluated after six months of intervention and six months of follow-up.

Results: After the follow-up, the intervention group improved the GDS-15 score (p <0.001), Duke-UNC-11 score (p <0.001), quality of life (EQ-VAS: p = 0.001, EQ-Index: p = 0.010), SPPB score (p <0.001), and reduced Fried's criteria (p <0.001) compared to the control group, which worsened Duke-UNC-11 score (p = 0.012) and EQ-Index (p <0.001). No significant changes in cognitive function were observed. Lastly, all significant changes in study variables after follow-up were significantly correlated with each other (p <0.05), indicating an interrelated evolution.

Conclusions: This 6-month educational program improved depressive symptoms, social support, quality of life, and physical frailty in community-dwelling frail and prefrail older adults, as observed after a 6-month follow-up.

Keywords: Aging; anxiety; cognitive health; health promotion; healthy aging; mental health; physical activity.

Publication types

  • Randomized Controlled Trial
  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Depression* / psychology
  • Depression* / therapy
  • Female
  • Frail Elderly* / psychology
  • Frailty* / psychology
  • Frailty* / therapy
  • Humans
  • Independent Living / psychology
  • Male
  • Patient Education as Topic* / methods
  • Quality of Life* / psychology
  • Social Support*